New Doctor, some patients already typed
Posted By: Lisa on 2008-12-01
In Reply to:
I got a new doctor. They girl who had been working for him left him in a big mess, undone dictations, etc. The office gave me a flashdrive to do with about 30 patients on it over the holiday weekend. Today they've told me ten patients had already been typed, how did I want to handle that? It seems they don't want to pay me for these. My husband says to bite the bullet and not charge them, since this is a new account and I'd like to keep it, is possible. What do you think? I know it's a land of confusion there from what is done to what is not done. Thanks!
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we should just once, as patients (sm)
go to the dr's office and waste THEIR time!!! Let them know how it feels for a change. But then again, the doc wouldn't wait two seconds on a patient, now would they? Wow, whatta double standard! 
Patients
On a really bad day, I feel like a vampire for making money off of other people's misfortunes.
Maybe sometimes we have too much time to think! I don't know.
Just because 2 patients have the
same dx does not mean they are treated the same and symtoms are the same in many dxs. Do you have your degree?
Well, too bad that they have 30 patients - sm
to see so they don't want to spell things out. Do they cut corners on patient care, as well, when they have 30 patients to see - or is that reserved for us peon MTs? So they're "frustrated" with 30 patients - well, cut your patient load! We're not paid to "guess" or have to look up everything they don't feel like spelling, especially other doc's names. Just won't do it.
By the way, I wonder if they know how many documents we have to type a day (30 maybe?) to even eke out simple minimal wage - but that's OK, I suppose, compared to their 5 or 6-figure salaries.
Just give everybody the bum's rush because you have 30 patients. Suppose we did the same?
A party for our patients...
Every year, the staff in our clinic takes it on ourselves to throw a party for our patients. We all cook finger food, make snack trays, cookies, baked good, cheezes, bread, meat trays, the works. We have breakfast foods and lunch foods. We decorate tables in our lobby to spread this out on. We usually do this one day a week for the four weeks before Christmas so many patients will get to enjoy it. We have coffee, hot chocolate, orange juice, cokes and punch. We have fruits and dips....something for everyone, even diabetics. The patients are touched that we go to the trouble and we are touched by how much they love it! These patients have gone through enough suffering with their diseases and some are elderly and don't have family members. Some tell us this is their only Christmas! We have been doing this several years now and the patients are beginning to tell us to be sure we appoint them to return on the days we are having our "Christmas spread." I just thought I'd share the Christmas party that means the most to me... and this is definitely it! Just the look on their faces as they are enjoying it is Christmas to me.
It is not our job to judges the patients sm
or why or where they seek treatment. It is our job to transcribe the dictated reports. If you don't like the healthcare system, then go out and change it.
Just how many lives do YOUR patients have?
Apparently mine have more than one because I have one dictator who likes to use the following phrase: Patient was told that he might have death and loss of current life. 
Now we have to insist patients
being treated are actually examined before treatment is rendered?
Wasn't it bad enough medicine when ER docs would proclaim a diagnosis before exam, only to have to backpedal after taking a look?? I guess if they are going to do things in that order, doing physical exams is going to result in their looking stuupid, so their solution is not to do that part.
Big grrrr.
If the patients were aware of that, they could
nm
Do any of you ever feel sad for the patients?
Maybe it is because I am on my period and am more emotional than usual, but today typing all these terminal cancer reports is making me want to cry. I feel so sad for the patient and their families. I just cannot imagine being told that I only have a few months left of my life. And the doctors sound so cold about it. I know they are very used to it....I just know that I could never be a doctor. I could never get used to telling someone they are going to die.
A question regarding patients' rights
I was just wondering this. My mother was recently sent to a "liver specialist" who is local gastrointestinal doctor because of concern over persistently elevated liver function tests. He drew a LOT of blood work on her and only told her that it looks like she might have a fatty liver. He set her up to come back in six weeks to "get the results of her lab tests." SIX WEEKS! With her being very concerned, of course, we immediately searched the net and found out that fatty liver occurs in patients 1). who drink alcohol (she never has), 2). Patients who are overweight (she is not) or 3). Patients with diabetes (she hasn't got that, either). It says that a liver biopsy is how they find this out. He never mentioned doing one of those. My question is.. would a physician want to wait 6 weeks to find out lab results? You know it doesn't take 6 weeks to get the results back, they probably had them back within a day or two. In the meantime, she is stressing big time about what could be wrong. 
Not sure when doctors graduate their patients but
I have boys and we stopped when my oldest was 11 because they always made them strip down to their undies for checkups and checked their privates and I didn't feel that was necessary and my boys hated it.
No thanks. Anorexic geriatrics patients don't do it for me.
x
Very true, but a list of patients?
An invoice by the patient? Some clients need to do their own book keeping. It is bad enough you have to worry about the content of the reports. To have to retype a patient name into an invoice with the line count is utterly ridiculous especially as an IC. IC's get taken advantage of. As an IC, yes you should be charging for "everything". If you're an employee, they can put it under "other duties as needed". Business is business. If it takes more time, that takes more money. End of story. Don't do nothing for nothing. Your clients sure do not. They go all this time with this Transcriptionist with her invoicing and then all of a sudden decide they want each patient name and line count? Cut me a break. You don't think there should be a charge for that? You can work for free, but I certainly WILL NOT! To make statements like be paid to walk to the computer is really being a bit of a smarty pants in my opinion. Keep it to yourself if you want to work for free, most people don't! Have a great day making nothing to do A LOT!
I read it... does it mean US patients would have to travel - nm
.
A lot of physicians refer to their patients
as heterosexual or having same sex partners, it is very relevant in some aspects, as in exposure to AIDS/HIV, etc.
It's called BEING FAIR TO PATIENTS
. Why should patient care suffer?! The patients haven't done anything wrong, even if management sucks. I thought that's what MTs were ultimately hired to benefit, the patients.
How does outsourcing dictation allow doctors to see more patients?
In an article in the MT News section, it states this. Do they really need to see more patients? Most of them herd them in and out like cows.
And that is because the GYN forgets to tell his patients that when changing pills you have to use an
alternate method of birth control for a month until the new level of hormones in the pills kick in, whether higher or lower. That is how come so many get pregnant on the "pill." The facts...my cousin is GYN and he tells all of his patients that.
Just wondering, for you MTSOs, about how many patients/reports per day...
For, say, an orthopedic surgeon, or a family practice doctor. Or, maybe, how many minutes of transcription on average per day.
THANKS.
these are the docs that I don't think care about their patients. my opinion. nm
ss
Call your doctor - this is not a doctor forum! nm
x
You know the difference between God and a doctor? God doesn't think he's a doctor. nm
X
The clock does play into how much time is spent with patients
The way the CPT codes bill insurance have guidelines for the physicians built into them that give amounts of time spent with the patient (in addition to certain information covered in the ROS/PE), especially in consultations (whether inpatient or out), hospital discharge codes and critical care time (inpatient or out).
Yes, that computer is in fact billing the insurance company because it not only saves not having to pay an MT, it bypasses a billing clerk (eliminating that salary), and if the doctor's office space is paid for by a hospital, that file is sent to the hospital's database where a *scrubber* compares what the MD submits versus coding guidelines. If it is an independent office, the MD can upload all that day's billing before he walks out the door and leave it unattended to update patient accounts and reconcile the days money intake.
In a nut shell, your doctor is no longer just practicing medicine. Your MD is doing the documentation and billing and saving money on two warm bodies.
I understand your concern as I see it more and more in today's medical care, but yes, this is the way things are going. I am fortunate that my MD has been very computer literate for a long time, so the amount of time he spends with his laptop is minimal. Once he enters the info, he kicks his shoes back and we chat and get into a deeper discussion both professionally and personally (we've known each other a long time). Give your MD a chance to play catch up to what he or she is doing with that computer and you should see a more relaxed physician soon.
Good luck.
We need actual examples of patients harmed by outsourcing
to take to the media. Then we could probably get enough interest for someone to do an expose on it.
I do reports all the time where patients have asthma, COPD, emphysema, and
even cancer and continue to smoke. In our local paper they are following a woman in her battle with cancer. She continues to smoke, as does her husband. They were broke before the cancer diagnosis, having to borrow daughter's babysitting money to pay bills. Just think how much money they've blown on cigarettes.
I've even known one man with a trach who smoked through his trach.
I wasn't clear. I guess patients' names is what irks me the most. SM
and you know how famous they are for dictating "Krenazcyssky, Jane, that's J-A-N-E.
neat web site 'chemo angels'. Help cancer patients
http://www.chemoangels.com/
Doctors patrolling themselves? What a joke! They barely have time to see ALL their patients....
Doctors today are totally incompetent for the most part. YOU cannot worry about it when it comes to transcribing their gawd awful reports. THAT is between the patient and the doc. Just knock the report out as fast as you can and make sure it's accurate and then after that, forget about it.
The docs make the big bucks - you don't! Let THEM worry about things that will eventually catch up with them, one of which is called the Karma bug, and that little bug ALWAYS bites those who don't deal fairly right in the butt! And big time, too! 
My nurse said most patients make calls with their cell, no problem
x
Just typed in an HP
Under the ROS the heading "Special Senses: Unremarkable"
I once typed for a doc who had
now that was funny!
Maybe that ad was typed by VR... or by an
It irks me no end that our country has shipped off a job to India/Pakistan, etc., that used to be considered important to the medical field, and which fed and housed many of our country's middle-class citizens. So now these foreigners are living the comfy middle-class life, and here I am, trying to rent an apartment and finding that my MT monthly gross pay doesn't qualify me for ANYthing that even distantly resembles a decent middle-class apartment. The only ones I can afford all have "Se habla espanol" in the ads, and of course you know who lives THERE! It's all the non-English-speaking illegals that we've pretty much given carte blanche to come ruin our country, after having done a real number on their own. I hope Uncle Sam enjoys paying for food stamps, welfare, and subsidized housing, 'cause that's where I'm headed unless this profession turns around.
Never typed an ESL??...sm
Now that is strange. As many ESLs as there are. And using the q.d. and h.s. they must have worked somewhere that they didn't use BOS.
--I think she has already typed them.
x
I have always typed mg/dl and I've been
transcribing early 20 years and have never heard anything about KCl. I currently work for a service that has a very rigid account and we have had to change several things to avoid confusion, though they have never mentioned this one. I would think it would be a personal preference. We use BOS as a rule of thumb, but on Tuesdays and the holiday following the third Saturday of the monh between 8 and 10 we do it this way, and then doctor X wants it done this way, which is totally different from standards, not a coherent dictation but he wants it his way.
Only typed verbatim twice
once for a Russian infectious disease MD. After one week of strict verbatim reports, evidently she got a talking to by the senior partner and her style became acceptable.
The hospital is one of the larget and most respected hospitals in the US. All residents much pass a week-long course dedicated strictly to how to chart, how to document, how to dictate. Each resident must personally sign his/her own name daily on a log in sheet and anyone who misses a day does not get to start with the rest of peers. One day is devoted SOLEY to HOW TO DICTATE and accepting full legal responsibility for the dictation. They have to sign an agreement that the hospital will not provide legal support if their documentation falls short of their standards and the resident has to provide his/her own funding against any lawsuit. If they dictate a reversal of pulse rate/respiratory rate, I could switch them, but I had to send it to QA who attached a note to the dictator covering the MTSO from any repercution.
Best dictators I EVER had!
I typed in my sleep once...sm
it was a late shift, about midnight (which is late for me) and I got up to go downstairs, move around, stay awake, came back and found I had typed something about a TV in a box...? So it can be done!
Proofing as you go...as in looking at what you typed?
Doesn't everyone? Or do some MTs watch TV or look up in the air while typing? LOL! That is not proofreading - proofreading is double-checking a finished document.
No, it was a report I typed. Now will you tell me off
a
I typed ENT for 6 years and
charged 14-16 cpl but that was about 4 years ago when you could charge that. I printed everything and picked up, delivered. I eventually had to drop the rate down to 10-12 cpl to keep the docs and then they found someone who would do their work for 8 cpl.
I think you are in the ballpark as well. Good luck.
I have to agree -- not only have I typed ERs for sm
people with cold symptoms, flu, snotty nose, etc., and wondered "why in the heck are they in the ER?," I have also witnessed it firsthand while waiting in the ER with my mom. She had congestive heart failure and towards the end we made frequent trips to the ER when she ended up unable to breathe and no doctor's office open. They always ended up admitting her anyway. But I watched the same thing that the poster below mentioned -- nonemergent cases clogging up the works because they treat the ER like a doctor's office.
And yes, there are "special circumstances" and such, but that was not the situation you were addressing. Sorry for the attacks you received. You just put in writing the thing that many of us have been thinking for quite awhile.
I HEAR ya, but only because you typed it.
I am with you. They really are clueless, aren't they!
Oh, okay, like not something we have never TYPED in a report before then...
Gotcha!
dictated / typed
Doctor says "jiddo, jiddo, jiddo" - what does this mean" Why.... 0-0-0 - OMG. The things we put up with for no money.
If they know they've been typed.
Why can't you skip over those patients since obviously they know other girl typed them.
Do not transcribe for free! Ever wonder why the other girl left?
"Qualified MT" just typed ...
Arthrosclerotic heart disease. This is an MT claiming to have 5+ years experience and wants to be paid .10 per line.
Any test I have taken I have typed
verbatim exactly because you do not know what they actually want. Also, need to follow BOS guidelines on tests as most MTSOs use these.
Sorry, typed the above without glasses
x
I recently typed an EGD....sm.
The patient had choked on a piece of meat and had it lodged in his throat. The whole report for some reason by hands did not want to type food...always foot. I felt pretty confident that I did a good job correcting all of them and sent the report on.
Two days later the doctor sends it back and asks me to change it. No big deal, must have made a different mistake....NO I was so mad at myself that I sent this report that stated "foot was removed from the esophagus". It was embarassing then but now it is pretty funny to me.
got it, DUH. havent typed a Pap in forever.
s
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